Comparative study on the clinical value of contrast-enhanced ultrasound- and CT-guided percutaneous puncture biopsy in peripheral lung masses

Abstract

Abstract:

ObjectiveTo compare the clinical value of contrast-enhanced ultrasound （CEUS）- and CT-guided percutaneous puncture biopsy in the diagnosis of peripheral lung masses.MethodsThe clinical data of 90 patients with peripheral lung masses who underwent puncture biopsy in Tumor Hospital Affiliated to Nantong University from October 2019 to December 2021 were retrospectively analyzed. According to different puncture guidance methods, patients were divided into CEUS-guided percutaneous puncture biopsy group （CEUS group,n=40） and the CT-guided percutaneous puncture biopsy group （CT group,n=50）, and the differences in puncture success rates, complication rates and other factors between the two groups were evaluated. Meanwhile, the correlations between microvascular density （MVD） and CEUS parameters were detected.ResultsThe puncture success rate in the CEUS group was higher than that in the CT group, but there was no statistically significant difference [97.5%（39/40）vs.92.0%（46/50）,P=0.337], and the complication rate in the CEUS group was significantly lower than that in the CT group [0（0/40）vs.12.0%（6/50）,P=0.032]. Compared with the CT group, the CEUS group has fewer punctures [（2.0±1.6） timesvs.（2.8±1.2） times,t=-2.43,P=0.018], shorter duration [（7.6±2.5） minvs.（15.3±2.6） min,t=-8.86,P<0.001] and lower cost of surgery [（1 308.4±545.6） yuanvs.（2 046.4±645.3） yuan,t=-2.01,P=0.046]. The MVD, CEUS peak intensity and enhancement index of lung adenocarcinoma were higher than those of squamous cell carcinoma [（25.4±4.9）/HP）vs.（16.6±7.3）/HP,t=3.43,P=0.002; （46.9±6.5）dbvs.（36.8±5.4）db,t=4.12,P<0.001; 5.2±1.4vs.4.1±1.2,t=3.27,P=0.006]. The peak intensity and intensity index of CEUS in lung adenocarcinoma or squamous cell carcinoma were positively correlated with itself MVD （squamous cell carcinoma：r=0.66,P<0.001;r=0.56,P<0.001; adenocarcinoma：r=0.62,P<0.001;r=0.70,P<0.001）.ConclusionAlthough CEUS-guided percutaneous puncture biopsy does not achieve a higher puncture success rate in the diagnosis of peripheral lung masses compared to CT, it really decreases the complication rate, and has the advantages of less time, low cost, no radiation and real-time dynamic monitoring, which is worth promoting in clinic. Moreover, there are correlations between CEUS quantitative parameters of adenocarcinoma and squamous cell carcinoma of the lung and MVD, which may be useful for diagnosis.

Key words:Lung neoplasms,Contrast-enhanced ultrasound,Percutaneous lung aspiration biopsy,Pathological diagnosis,Microvascular density

Chen Huangjing, Zhu Pengfei, Zhang Qing, Chen Guifang, Yang Chunlin, He Ying. Comparative study on the clinical value of contrast-enhanced ultrasound- and CT-guided percutaneous puncture biopsy in peripheral lung masses[J]. Journal of International Oncology, 2022, 49(8): 459-463.

Figures/Tables4

项目	CEUS组（n=40）	CT组（n=50）	χ²/t值	P值
性别
男	31（77.5）	32（64.0）	1.93	0.165
女	9（22.5）	18（36.0）	1.93	0.165
年龄（岁）	70.9±9.3	69.1±9.1	-1.52	0.184
病灶位置
左肺	20（50.0）	24（48.0）	0.04	0.850
右肺	20（50.0）	26（52.0）	0.04	0.850
病灶最大直径（cm）	6.3±2.3	5.3±2.4	1.42	0.220
穿刺次数（次）	2.0±1.6	2.8±1.2	-2.43	0.018
穿刺时长（min）	7.6±2.5	15.3±2.6	-8.86	<0.001
手术费用（元）	1 308.4±545.6	2 046.4±645.3	-2.01	0.046

病理类型	CEUS组（n=39）	CT组（n=46）	χ²值	P值
腺癌	14（35.9）	21（45.7）	4.08	0.554
鳞状细胞癌	13（33.3）	12（26.1）
腺鳞癌	1（2.6）	0（0）
小细胞肺癌	4（10.3）	3（6.5）
炎性病变	5（12.8）	4（8.7）
其他类型恶性肿瘤	2（5.1）	6（13.0）

组别	MVD（个/HP）	CEUS峰值强度（db）	增强指数
鳞状细胞癌（n=13）	16.6±7.3	36.8±5.4	4.1±1.2
腺癌（n=14）	25.4±4.9	46.9±6.5	5.2±1.4
t值	3.43	4.12	3.27
P值	0.002	<0.001	0.006

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